Department of Health Sciences, Physician Assistant Program: Policy on Preclinical Summative Assessment

Unit Policy

Title

Department of Health Sciences, Physician Assistant Program: Policy on Preclinical Summative Assessment 

Introduction

Purpose

This Policy establishes requirements and processes for Physician Assistant (PA) Program (Program) students (Students) regarding the Preclinical Summative Assessment (PCSA).

Scope

This Policy applies to all Students who matriculate into the Program.

Policy

Policy Statement

Students must receive a passing grade on both components of the PCSA in order to progress from the Preclinical Phase to the Clinical Phase of the Program. The PCSA is comprised of the following two (2) components:

  1. A Written Examination; and
  2. Objective Structured Clinical Examinations (OSCEs).

Students take the Written Examination and OSCEs at the end of the third semester of their Preclinical Phase (November-December). The dates for the Written Examination and OSCE vary year to year and are published for each cohort within the Program’s online learning platform at the beginning of the first semester of the Preclinical Phase.

Examination Attendance

Students are required to attend the Written Examination and OCSEs. A Student who fails to take an examination due to Unapproved Absence or Excessive Tardiness may be referred to the Student Progress Committee for further consideration of professionalism concerns and for determination of whether the Student will be scheduled for a make-up examination.

Make-Up Examinations

Make-up examinations for Approved Absences are scheduled by the Director of Preclinical Education (DPCE). Make-up examinations for Unapproved Absences or Excessive Tardiness, if determined appropriate by the Student Progress Committee, will be scheduled by the Director for Preclinical Education.

Written Examination

Details

The Written Examination is a timed examination comprised of one hundred and twenty (120) multiple-choice questions. All Students without approved testing accommodations will have a time limit of 120 minutes for the examination. Students with approved testing accommodations through the University Compliance Office are required to make every effort to take the examination at the University Compliance Office Testing Center.

Content

Students are provided with a Blueprint and topic list specifically for the Written Examination. The content includes topics covered in the preclinical phase. The examination assesses Students in Clinical Vignette Format to assess their critical thinking and problem-solving abilities.

Grading Threshold

The passing threshold for the Written Examination is a minimum score of 70%.

Remediation
Failure of First Attempt

If a Student fails their first attempt of the Written Examination by not achieving a minimum score of seventy percent (70%) OR has a score of a “zero” recorded due to Excessive Tardiness or Unapproved Absence:

  1. The Student will be referred to the Student Progress Committee.
  2. The Student will be placed on Academic Probation.
  3. The Student will be required to meet with the course director for PASC 730 and their academic advisor within five business days of the examination to discuss performance, remediation assignments, and improvement strategies.
  4. The PASC 730 course director will, in conjunction with the Student Progress Committee, establish a date for the Student to complete any remediation assignments, including any Individualized Learning Plans (ILPs) developed. Timing of retesting will be determined based on the Student’s remediation needs.
  5. The Student’s ability to retest will be contingent upon their successful completion of all remediation assignments and continued adherence to all expectations and programmatic policies. The Student will be retested through a second multiple-choice examination which reflects the same blueprint and topic list as the first examination. The passing threshold for the retest is 70%.
  6. The Student’s Program completion may be delayed.
Failure of Second Attempt

If a Student fails their second attempt of the Written Examination:

  1. The Student will be referred back to the Student Progress Committee due to continuing academic difficulty.
  2. The Student Progress Committee, in conjunction with the PASC 730 course director, will determine the best course of action for the Student, which could be any of the following actions, alone or in combination:
    1. Require the Student to undergo additional Remediation and to retake the Written Examination.
    2. Require the Student to Decelerate and repeat the preclinical phase of the Program’s curriculum.
    3. Consideration of the Student’s dismissal from the Program.

A Student may not retake the Written Examination more than two (2) times. Should a Student Decelerate and repeat the PASC 730 course, the Student will be offered the same number of testing, Remediation, and retesting opportunities as the rest of the cohort into which they Decelerate.

OSCE

Details
  1. The OSCEs are comprised simulated patient scenarios that have been created by principal faculty, utilizing the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) standards, standards of the profession, and programmatic competencies as guidance.
  2. Instructional objectives and rubrics are published to help guide Student preparation.
  3. Each simulated patient encounter scenario has a designated time limit for each component. All Students must complete each component within its time limit, unless otherwise allowed by reasonable accommodations. Grading will cease at the time limit for each component.
    1. Any accommodations must be established with the University Compliance Office in advance of this assessment. Accommodations cannot be applied retroactively.
  4. The components of the simulated patient encounters include:
    1. Timed preparation for the encounter;
    2. Timed performance of the encounter, which may include (but is not limited to) obtaining a history, performing a physical examination, administration of diagnostic testing, interpretation of diagnostic testing, performing Technical Skills, patient education, and/or counseling;
    3. Timed preparation of an oral presentation;
    4. Timed delivery of oral presentation to a faculty member; and
    5. Timed and proctored written documentation.
Grading Threshold
  1. Students must achieve a minimum score of 70% on each OSCE simulated patient encounter scenario.
  2. Each OSCE encounter grade will be calculated using the following weighted scoring from each component of the encounter:
    1. Standardized patient encounter (including performing Technical Skills, as appropriate): 60%
    2. Oral presentation: 20%
    3. Written documentation: 20%
Remediation
Failure of First Attempt

In the event a Student does not achieve a minimum score of 70% on their first attempt of an OSCE simulated patient encounter scenario OR has a score of a “zero” recorded due to Excessive Tardiness or Unapproved Absence:

  1. The Student will be referred to the Student Progress Committee.
  2. The Student will be placed on Academic Probation.
  3. The Student will be required to meet with the PASC 732 course director and their academic advisor within five business days of the examination to discuss performance, Remediation assignments, and improvement strategies.
  4. The PASC 732 course director will, in conjunction with the Student Progress Committee, establish a date for the Student to complete any Remediation assignments, including any Individualized Learning Plans (ILPs) developed. Timing of retesting will be determined based on the Student’s Remediation needs and logistics required to conduct another simulated patient encounter.
  5. The Student’s ability to retest will be contingent upon their successful completion of all remediation assignments and continued adherence to all expectations and Program policies.
  6. The Student will not be assigned the same faculty grader for their OSCE retest as they were assigned for their first OSCE attempt.
  7. The Student must pass each retested OSCE encounter with a minimum weighted score of 70%.
  8. The Student may be delayed in progressing into the clinical phase, which may ultimately delay the Student’s Program completion.
Failure of Second Attempt

If a Student does not achieve a minimum score of 70% on their second attempt of an OSCE simulated patient encounter scenario OR has a score of a “zero” recorded due to Excessive Tardiness or Unapproved Absence:

  1. The Student will be referred back to the Student Progress Committee due to continuing academic difficulty.
  2. The Student Progress Committee, in conjunction with the PASC 732 course director, will determine the best course of action, which could be any of the following actions, alone or in combination:
    1. Require the Student to undergo additional Remediation and retake their failed OSCE/s;
    2. Require the Student to Decelerate and repeat the preclinical phase of the Program’s curriculum.
    3. Consideration of the Student’s dismissal from the Program.

A Student may not retake an OSCE more than two (2) times. Should a Student Decelerate and repeat the course, the Student will be offered the same number of testing, remediation, and retesting opportunities as the rest of the cohort into which they Decelerate.

Definitions

Academic Probation – A formal status assigned to a Student who fails to meet the Program’s defined academic standards. While on Academic Probation, Students remain enrolled in the Program but are subject to additional oversight and support measures, which may include mandatory meetings with faculty, completion of remediation assignments, and adherence to learning contracts. Academic Probation serves as an opportunity for Students to improve academic performance and return to good academic standing; however, continued deficiencies in academic performance or nonadherence to Program policies and academic standards may result in further actions by the Student Progress Committee, including Deceleration or dismissal from the Program.

Approved Absence: A Student’s absence from an examination for which the Student received prior approval from the Program’s Director of Preclinical Education (DPCE).

Blueprint: A structured examination outline with percentage of exam content dedicated to each area (e.g. percentage of questions related to Cardiology, Pulmonology, etc.).

Clinical Phase: The second phase of the Program’s curriculum following a Student’s successful completion of the Preclinical Phase. The Clinical Phase consists of three semesters focused on supervised clinical rotations in a variety of healthcare settings and emphasizes the application of the medical knowledge, patient care, professionalism and cultural humility, interpersonal and communication skills, systems-based practice, and self-assessment skills acquired during the Preclinical Phase with the overall goal of preparing Students for entry into the PA profession.

Clinical Vignette Format (in the context of a multiple-choice exam): Patient-related cases and scenarios that are often used to describe a problem in a multiple-choice examination.

Competencies: The medical knowledge, interpersonal, Clinical and Technical skills, professional behaviors, and clinical reasoning and problem-solving abilities required for PA practice.

Deceleration: The removal of a Student from the entering cohort where the Student remains matriculated in the Program. Deceleration results in a Student taking a leave of absence from the Program and resuming their academic progress with the Program’s next cohort.

Excessive Tardiness: Occurrence of a Student being more than fifteen (15) minutes late for an examination, as determined by the Director for Preclinical Education. A Student who is excessively tardy for an examination will not be permitted to sit for that examination and, as a result, will receive a score of “zero” on the examination. 

Individualized Learning Plan (ILP): A structured document provided to Students who do not meet the passing threshold of the Preclinical Summative Assessment (Written and/or OSCEs). The ILP addresses academic deficiencies and supports student improvement through four (4) core components: Review, Reflect, Relearn, and Retest.

Objective Structured Clinical Examination (OSCE): A standardized assessment tool used to evaluate a Student’s Clinical and/or Technical skills in a simulated environment.

Preclinical Phase: The first year of the Program’s curriculum encompassing both didactic and experiential learning. The Preclinical Phase consists of three semesters designed to provide foundational medical knowledge, patient care, professionalism and cultural humility, interpersonal and communication skills, systems-based practice, and self-assessment skills that prepare Students for the Clinical Phase of the curriculum.

Preclinical Summative Assessment (PCSA): A two-part, must-pass element of the Program curriculum for Students to progress from the preclinical to the clinical phase of the Program.

PCSA Written Examination: A multiple-choice examination designed to assess a Student’s medical knowledge. The PCSA Written Examination is the final examination of the PASC 730 Clinical Medicine III course. 

PCSA OCSEs: A series of examinations that consist of simulated patient encounters designed to assess a Student’s mastery of the Program’s Competencies. The PCSA OSCEs are embedded within the PASC 732 Patient Assessment II course.

Remediation: The Program-defined process for addressing deficiencies in a Student’s knowledge and skills, such that the correction of these deficiencies is measurable and can be documented.

Technical Skills: Technical skills are procedural skills. Examples include, but are not limited to, performing diagnostic studies, intravenous line insertion, surgical scrubbing, cast application, and suturing.

Unapproved Absence: A Student’s absence from an examination for which the Student did not receive prior approval from the Program’s DPCE. A Student with an Unapproved Absence for an examination will receive a score of “zero” on that examination.

Related Requirements

External Regulations

 

 

Unit Policies, Standards, and Procedures 

  • Department of Health Sciences, Physician Assistant Program Policy on Student Progress Committee
  • Department of Health Sciences, Physician Assistant Program Policy on End of Curriculum Assessment
  • Department of Health Sciences, Physician Assistant Program Policy on Grading

Contact Information

Primary Contact

Name: Administrative Support Specialist

Telephone: 919-962-8008

Email: paprogram@unc.edu

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